Care workers

Talking to a group of newcomers to the field
a dozen years ago on some of the simple things we can bear in mind about
the children and families we work with “and about ourselves “if we are
interested in ...

Staying sane as a child care worker

Brian Gannon

As a child and youth care worker in daily contact
with children and young people, you assume an extremely important adult
role. You spend a great deal of time with them, you observe them and
interact with them, you come to know them and their ways. All growing
children, from this interaction with parents and other adults, need:

confirmation of their positive growth and
achievements;

reassurance and assistance through periods of
doubt and difficulty,

developing new age-appropriate attitudes and
behaviours

comment and correction when their behaviour is
unacceptable or maladaptive.

You as a care worker are entrusted with maintaining
these tasks of upbringing. You represent the values and norms of your
society and of the kids' families, as well as the philosophy and goals
of the agency you work for. In turn, you also represent the children and
youth in your group, and share their hopes and aspirations for their
futures as mature, responsible and independent adults. Your daily task
is one of working at this interface between the children and their
worlds, helping them to understand both themselves and the families and
communities in which they live, and giving them the confidence and
skills they need to cope with the demands of life and to fulfill their
own individual goals.

This would be challenge enough for any parent or
educator, but child and youth care workers have the added challenge of
having to work with difficult, deprived and troubled kids. Such children
often bring into the group the disadvantages of their past lives,
distorted attitudes and experiences, and much behaviour which has to be
"tuned" and even unlearned. And although, like all children, they
require both understanding and firmness, the care-giver working in such
specialised circumstances needs considerable knowledge, skill and
sensitivity. It is this which makes the way we respond to children's
behaviour so critically important, and which makes our work generally so
difficult and demanding.

Ruling, reacting or responding?
In this field of practice one sees two extreme methods of coping with
the behaviour of difficult children. On the one side are those who
rule children, prescribing desired behaviours and not permitting
any expression of behaviours which may be disquieting or threatening.
The problem with this is that the children's behaviour is imposed,
standardised and uniform, and there is no way of seeing how they would
really behave if the constraints upon behaviour were removed, or whether
or not they have learned for themselves how to handle their impulses and
feelings. The danger is that perhaps we will only discover this too
late, when they leave our program, when the strict regimen is removed,
and with it our last opportunity for helping.
At the other extreme are those care workers whose lives are in turn
ruled by the children's behaviour. Many workers start their day with a
sense of pessimism and foreboding “what sort of a day will the children
give me today? “and they wait for the problems and incidents to be
thrust at them, and without fail they come! Such workers often go to bed
physically and emotionally exhausted, having done little more than
attend to the crises, stop the battles and put out the fires. They feel
they have worked hard (and they have) but it is questionable whether
progress has been made either in individual lives or in the group as a
whole; enough that the fort has been held for one more day. The
initiative has been left in the hands of the children and dictated by
their problem behaviour. The child care worker has simply reacted and
through the day has become less and less self-possessed and resourceful,
and may well come to wonder whether it is all worthwhile.

If child and youth care workers are to see
themselves as a teachers, guides, counsellors and parenting figures to
the children, then they must at least retain the initiative, together
with the responsibility for what happens in their group. By simply
reacting, they lose this initiative and the children call the shots “and the care workers' role is then very much in doubt. By the same
token they need to be aware of how each child is doing, and therefore
they need to give the children opportunities for making choices and
decisions, for trying out new behaviours and for testing out the
possibilities and limits of their environment.

The child care worker’s role is not unlike that of a
tennis coach who may have some very promising and very unpromising
trainees. Child care, like a tennis match, is a dialogue. The trainees
must show what they can do and the coach must encourage and correct “and then both try again. There are times when the coach directs the
activity, directing his efforts towards a specific limitation or failing
in his trainee; and then there are times when the trainee dominates the
dialogue, asking for help with a special skill; and there are times when
they will play against each other, when each has a chance to serve and
so control the movement and pace of the game. The trainee will never
develop exactly the same playing style as his coach, and, contrary to
the coach’s advice, may prefer a certain grip or technique or speciality
stroke. But the end result, the criterion for the coach’s success, is
whether or not his trainee can hold his or her own in the game of
tennis, either modestly or with high achievement.

That analogy is easily translated into the
terminology of child care. The child and youth care worker needs to be
aware of the limitations and failings of his charges, and must be ready
to respond to the special needs the children demonstrate from time to
time. As the children grow they, too, need to "play against" the adults
to reassure themselves that they can master their own world in their own
way. And though the children will never adopt exactly the same lifestyle
as the care worker, he or she will have helped them to the point where
they can hold their own in the game of life, whether modestly or with
high achievement.

Understanding unacceptable behaviour
We often forget that behaviour is a language, the medium through which
people express their inner selves, and that insofar as care and
treatment is concerned it is the underlying message which is often more
important than the grammar and syntax of behaviour. Child care workers
often make the mistake of giving all their attention to the correctness
and acceptability of behaviour without also attending to its underlying
meaning. Difficult behaviour is usually the symptom of a problem and not
the problem itself.

If we were asked for a list of difficult behaviours,
we might include the following: rudeness, vulgarity, lying, stealing,
cheating, defiance, laziness, unwillingness to contribute, running away,
swearing, disruptive behaviour, bullying, fighting, sexual acting out,
sulkiness, rebelliousness, bed-wetting or soiling ... and lots more.
These behaviours are difficult, but often we experience them as
threatening and unacceptable because we feel helpless in the face of
them, we do not understand them, we wish they would stop. They are
often, in fact, the problems of the children as we experience them,
our problems with the children.

Here is another list of problems with children:
fear, resentment, sorrow, anger, loss, poor ego control, impulsivity,
mistrust, hostility, over-stimulation, lack of verbal skills, anxiety,
poor socialisation, cultural deprivation, poor adult models, insecurity
... again, lots more. Could this be the same list as before, but this
time the problems as the youngsters experience them? If we see
problem behaviour in this way we are developing an understanding and
empathy with the kids, and recognising more helpful tasks ahead of us.

Factors underlying behaviour
Few kids decide to be "bad" or "difficult". There can be many factors
which lie behind and influence children's behaviour, and these are are
particularly common in children who come to the doors of programs like
ours. Many of these factors are negative; others are just
different, and we must identify which is which. These factors may
include:

Different social and cultural experience.
Deprived children often come from a social and cultural milieu which is
foreign to us. Poverty, unemployment, low educational attainment,
inadequate and overcrowded housing, poor social environment, and perhaps
alcoholism and violence, often constitute the children's early
environment from which they have learned much of their behaviour and
language “which we may consider "bad" but which are, for them, normal.
For such children swearing may be common currency and stealing a method
of survival, and child care workers must distinguish carefully between
what may be called immoral and what amoral.

Level of socialisation.
Social norms differ from suburb to suburb, from household to household.
A child may have learned to conform to norms and values which we would
find uncomfortable. Or worse, with inadequate parenting or absent
parents the child may be poorly socialised since nobody has reflected
for her what is acceptable and unacceptable behaviour. Such children
cannot be judged for not knowing what they have never been taught.

Nobody "to behave for".
Except for the autistic, behaviour is a transitive phenomenon, and
behavioural training is only effective within a relationship with a
significant “valued and valuing “other person, normally the parent.
Socialisation outside of such a mutual and caring relationship is a grim
and joyless thing. "Every child needs at least one person who is really
crazy about him" suggests Bronfenbrenner, and until he finds that
person, confident growth and socialisation must wait. The children
growing up in a single-parent family where the parent is out at work all
day will have little opportunity to gain approval and appreciation for
their behaviour. There is nobody "to notice" them.

Ego awareness and ego strength.
The neglected child has often not built up an ability to make sense of
his environment, to mediate in an acceptable way his needs and desires,
to tolerate frustration and wait for his needs to be fulfilled, or a
sense of personal responsibility for his actions. Such children may be
pitifully anxious and impulsive.

Attitude.
Many children feel deserted and abused, angry at the way they have been
treated, and they distrust authority or adult figures in general. Such
children cannot be expected automatically to give their allegiance to
someone else, or, worse, to a 'system' such as might exist in a group
home, until they have proved themselves and the youngsters feel
confident and trusting in them. In the meantime, their pessimism and
feelings of betrayal may present with aggressive or anti-social
behaviour.

Temperament.
Remember, too, that no matter what their backgrounds, children and youth
are not all alike temperamentally, that some are naturally reserved and
quiet while others are naturally more boisterous and loud. Temperament
is being recognised anew as a major factor which distinguishes children
and their styles of behaviour from one another and we bear this factor
in mind when considering depression and withdrawal on the one hand and
anxious over-stimulation or rowdiness on the other.

In summary, our response to children's behaviour
requires some knowledge of the dynamics of behaviour generally, and
knowledge of particular kids” limitations and incapacities. We then know
where we need to address our best efforts in each specific case. When
children are just naughty, then it is their behaviour which concerns us.
But for most children in care it is the meaning underlying their
behaviour which need our understanding and attention.

Understanding our own reactions
As suggested above, child and youth care may be seen as a dialogue, and
if an understanding of the child is important on one side, then an
understanding of ourselves as child and youth care workers is equally
important on the other side. What are some of the factors which
influence our reactions to children's behaviour, and which make it
difficult for us to respond helpfully and constructively (like the
tennis coach)?

Fear
Make no mistake, entering the world of troubled children, no matter what
books you have read and what training you have received, you will
repeatedly be exposed to discomfort, embarrassment, anxiety, or just
plain fear. At the lower end of the scale you may simply fear being made
to feel like an idiot. Further up the scale you will be anxious because
you don't know enough about the kids and their problems, and you will
fear that you are being useless or perhaps that you will make mistakes.
And then there will be experiences with really scary kids and family
members, the times when (you will get to recognise) you shouldn't be
working alone by yourself anyway.

Fatigue, time pressure and burn-out
Most child care workers have to cope with large numbers of children over
extended periods. It is difficult to be spontaneous and resourceful when
one is physically and emotionally tired. This could be due to external
factors such as unreasonable agency demands, client-staff ratios and
working conditions. It could be that your team has been through a tough
time “difficult behaviour is contagious and 'situations' frequently
arise in twos or threes. It could be due to internal factors such as our
own physical and mental shape, our planning skills and management of our
time. Whichever, our health and well-being is an area which must be
attended to before we can expect to be able to respond positively to
children's behaviour.

Conflicts in agency priorities.
We may work for an organisation which has difficulty in seeing that a
group of hurt, anxious or angry youngsters will produce some disturbing
behaviour. The organisation may utterly under-estimate the capacity and
resources it should apply to the job, or its philosophy may
unrealistically value "good" behaviour above treatment needs. We, in
turn, are anxious that the clients” continuint troubled behaviour will
reflect negatively on our ability to handle the job: we need to show our
superiors that we have the situation under control, yet we also want to
respond to the children's real needs ... One would wish to avoid any
conflict of loyalties where one’s employers are concerned, but these
leads to considerable staff anxiety, and perhaps some renegotiation and
discussion of the agency’s mission and strategy will be necessary.

The protection of others in the group, balancing
needs.
Aggressive and acting out behaviour, for example, is experienced as
threatening not only by us but also by the other children in the group,
and we have a duty to them to preserve a safe environment. We can become
undecided when some youngsters need opportunity to deal with painful
issues or try out their limits, while others are needing reassurance and
predictability. Always, there are some behaviours which we cannot
permit. At the same time, remember that other children can only benefit
by observing the constructive resolution of conflicts in the
group, and we certainly shouldn’t over-protect them to the extent that
there are never any "family rows". Children will usually come to trust
an environment (and by extension, a world) in which they see problems
together with the solving of problems.

Our own values and standards.
We may react punitively and appear rejecting when children offend
against our personal values and codes of conduct. We may feel that we
are also members of the group and also have rights, and bad language,
for example, may be offensive to us. There is no harm in expressing our
preferences, but we should bear in mind the social and cultural factors
in the children's lives which we discussed earlier, and be careful not
to convey rejection because of an essentially cosmetic failing on their
part.

Rigidity and sensitive issues of our own.
Further to the above, we need a deep understanding of ourselves and our
own susceptibilities, for few of us reach adulthood having disposed of
all our issues from childhood and adolescence. At some stage we
have experienced strong feelings of fear or hurt, and we often bring
with us into this work some unresolved material of our own, usually
related to such powerful human themes as acceptance, authority,
sexuality, death, etc. When children present behaviour related to themes
like these, there may be areas about which we feel uncomfortable and
unable to tolerate or deal with objectively, and we freeze. This may
make children even more anxious about similar areas in their own lives,
and for the sake of all concerned we need to recognise and face our
personal "keep off" issues which lead to rigidity. Never be afraid to
admit that you have some "no go" areas which it might be better to allow
colleagues to handle in your place.

Insufficient knowledge.
Behaviour which is beyond our experience or understanding is often
frightening and we prefer to deny it or eradicate it. When we are
confronted by bizarre or exaggerated behaviour we should never hesitate
to discuss it with our supervisors. In fact whenever there is anything
in children's behaviour which confuses us, for example failure to learn
from their experience or repetitive episodes which don’t respond to our
interventions, we should refer these to colleagues or superiors. In this
way we gain insight into and mastery over our work, and we widen our own
repertoire.

Idealism.
Many of us come into this work with high ideals which we are reluctant
to let go. The reality of hurt and pain and anger in the children's
lives conflicts with our expectations of warmth and gratitude, of being
able to preside over "one big, happy family". Such idealism may lead us
to prefer not to see the reality, and children may feel guilty and
unacceptable for spoiling our fantasies and not fitting into our dreams.

Impatience.
Child care workers, probably more than any other professionals, often
have to wait a long time to see results. The mending of broken lives may
take years. Children take a long time to regain belief in themselves and
in others; they reach plateaus in their healing and development when not
much seems to be happening, when no progress is visible; often they
stumble, lose confidence and hope, are hurt again, and seem to go
backwards. We sometimes have to face the fact that some children are not
going to get better at all. This is very discouraging for the workers
who may have no comfort beyond that of knowing that they are doing their
best, with perseverance, and skill, and great generosity.

Ownership of the problem.
Many child and youth care workers tend to make the children's problems
their own, and so may become more anxious than they need to be when
confronted by problem behaviour. As a care worker you have offered to
assist in the solution of problems, but the problems are not yours. The
problems belong to the children, often to the whole family or even the
whole neighbourhood; you may be sympathetic and empathetic, you may do
your best to help clarify and objectify the problems that you meet, you
may be with them whilst they work through the feelings and issues
associated with the problems, you may assist them in seeking solutions,
but in the end they should be their solutions to their
problems, and not yours.

These are some of the factors which often cause
child care workers to react rather than respond helpfully to troubling
behaviour. Knowing ourselves and understanding our expectations and
motivations can overcome many of these. However, the worker should not
bear all responsibility for this alone, for he is part of a wider
profession and part of a wider team, and must draw on the strengths and
resources of both.

Things to take on the journey
Child care workers often see themselves as lone adults in groups of
children and families. Unlike other categories of workers, they have no
tools in their hands; they work with neither typewriter nor notebook,
neither hammer nor saw. It seems to them that in their work they must
use themselves as the tools of their trade, and this means
risking themselves. As is to be expected when working with troubled
children, there is usually more give than take, and in such an economy
the books of job satisfaction will not balance.

There are four essential anchors which the child
care worker needs to prevent the dangers of personal exposure in
residential treatment which lead to reaction rather than response:

A Philosophy of Child Care.
The worker needs a clear understanding of the aims and goals of the
trade against which to measure each interaction with a child. "What I am
doing now, does this fit with our philosophy?" The ability to step back
from a situation to consider it in this light makes it easier to respond
helpfully “and less easy simply to react.

Knowledge of oneself as a member of a team.
No care worker should be left entirely to his or her own devices in the
treatment of troubled children. Workers must know that they can refer
matters at all times to superiors or colleagues, and so gain an
objective picture of a child's behaviour and the task which that
behaviour implies. It is essential to be able to share with colleagues
questions such as “What is actually happening here?' and 'What is the
best response to make?'

The real team tool under this heading is
supervision. Do you have an assigned person just up the passage
with whom you can check out your observations, your meaning-making and
your actions, your questions about things you don't understand, why is
this not working “or why did this intervention work? Supervision is
something which should be available to you on the floor, when and where
you are working; it should also be available to you on a regular basis
so that you can examine larger time samples and at a distance “not only
when you are in the heat of confusion or doubt, but when you can reflect
how your skills and practice are developing over time. You are not
receiving this kind of supervision? Ask for it!

Participation in a treatment plan.
Many children's programs fail to define the tasks which need to be
accomplished in respect of individual children, and workers are left at
best with a vague and generalised idea of what we are aiming at. If some
systematic assessment is done, then for each child there are specific
goals to be reached within a plan, and child care workers are greatly
helped in their work when these are clearly spelled out. Our responses
may then be made in terms of these goals, and everything we do with the
children becomes more purposeful “and, again, less likely to be mere
reactions.

Practice skills.
We never stop learning how to listen, how to respond. We often answer
youngsters in an oppositional way which forbids further discussion; with
an air of hasty judgement or finality which allows no exchange of ideas;
or we ask literal, intellectual questions ("Why?" being the worst) which
the kids cannot answer. They walk away frustrated and unlistened to,
often with negative behavioural consequences. The skill of being able to
listen, and making time to listen ("Tell me about it") draws much of the
sting of their hurt, indecision and anger “and teaches us more and more
about the children we work with.

Conclusion
The kids you work with are going to be difficult. That’s part of the
deal. This can be scary and discouraging. But we will cope with the work
better if we understand the background and meaning of their thinking and
behaviour, and if we understand our own shortcomings and skills, our own
abilities and vulnerabilities. Above all, we should refuse to go into
the field without a battle plan, a shared philosophy, and without the
back-up and support of superiors and colleagues. It is our own
responsibility to see to it that our personal skills and knowledge are
honed and sharp at all times.